Federal
Payment to the hospital.
42 CFR § 424.126
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8 segments
42 CFR § 424.126
42 CFR § 424.126
Payment to the hospital.
(a)
Conditions for payment. Medicare pays the hospital if it—
(1)
Has in effect an election that—
(i)
Meets the requirements set forth in § 424.104; and
(ii)
Reflects the hospital's intent to claim for all covered services furnished during a calendar year.
(2)
Claims payment in accordance with §§ 424.32 and 413.74 of this chapter; and
(3)
Submits evidence requested by CMS to establish that the services meet the requirements of this subpart.
(b)
Amount of payment. Payment is made (in accordance with § 413.74 of this chapter) on the basis of 100 percent of the hospital's customary charges, subject to the applicable deductible and coinsurance provisions set forth elsewhere in this chapter.
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